How Older Adults Can Maintain A Healthy Sex Life

older couple holding hands and wading into the ocean

by Patricia LaCroix, Contributing Writer

Many people want and need to be physically close to others as they grow older. For some, this manifests as a desire to continue an active, satisfying sex life. But as people get older, doing so might mean adapting sexual activity to accommodate physical, health, and other changes that come with age.



What are normal sexual changes due to aging?

Normal aging brings physical changes in both men and women. These changes sometimes affect the ability to have and enjoy sex.

A woman might notice changes in her vagina. As a woman ages, her vagina can shorten and narrow. Her vaginal walls can become thinner and a little stiffer. Most women will have less vaginal lubrication, and it might take more time for the vagina to naturally lubricate itself. These changes could make certain types of sexual activity, such as vaginal penetration, painful or less desirable. If vaginal dryness is an issue, using water-based lubricating jelly or lubricated condoms might be more comfortable. If a woman is using hormone therapy to treat hot flashes or other menopausal symptoms, she might want to have sex more often than she did before hormone therapy.

As men get older, impotence (often referred to as erectile dysfunction, or for short, ED) becomes more common. ED is the loss of ability to have and keep an erection. ED can cause a man to take longer to have an erection. His erection might not be as firm or as large as it used to be. The loss of an erection after orgasm might happen more quickly, or it could take longer before another erection is possible. ED is not a problem if it happens every now and then, but if it occurs often, the senior should talk with his doctor.

What causes sexual problems for older adults?

Some illnesses, disabilities, medicines, and surgeries can affect an older adult’s ability to have and enjoy sex.

Arthritis. Joint pain due to arthritis can make sexual contact uncomfortable. Exercise, drugs, and possibly joint replacement surgery might help relieve this pain. Rest, warm baths, and changing the position or timing of sexual activity can be helpful.

Chronic pain. Pain can interfere with intimacy between older people. Chronic pain does not have to be part of growing older and can often be treated. But, some pain medicines can interfere with sexual function. Always talk with your doctor if you have side effects from any medication.

Dementia. Some people with dementia show increased interest in sex and physical closeness, but they might not be able to judge what is appropriate sexual behavior. Those with severe dementia might not recognize their spouse or partner, but they still desire sexual contact and might seek it with someone else. It can be confusing and difficult to know how to handle this situation. Here, too, talking with a doctor, nurse, or social worker with training in dementia care can be helpful.

Diabetes. Diabetes is an illness that can cause ED in some men. In most cases, medical treatment can help. Less is known about how diabetes affects sexuality in older women. Women with diabetes are more likely to have vaginal yeast infections, which can cause itching and irritation and make sex uncomfortable or undesirable. Fortunately, yeast infections can be treated successfully.

Heart disease. Narrowing and hardening of the arteries can change blood vessels so that blood does not flow freely. As a result, men and women can have problems with orgasms. For both men and women, it might take longer to become aroused, and for some men, it may be difficult to have or maintain an erection. People who have had a heart attack, or their partners, might be afraid that having sex will cause another attack. Even though sexual activity is generally safe, always follow your doctor’s advice. If your heart problems get worse and you have chest pain or shortness of breath even while resting, your doctor might want to change your treatment plan.

Incontinence. Loss of bladder control or leaking of urine is more common as people, especially women, grow older. Extra pressure on the belly during sex can cause loss of urine. This can be helped by changing positions or by emptying the bladder before and after sex. The good news is that incontinence can usually be treated.

Stroke. The ability to have sex is sometimes affected by a stroke. A change in positions or medical devices may help people with ongoing weakness or paralysis to have sex. Some people with paralysis from the waist down are still able to experience orgasm and pleasure.

Depression. Lack of interest in activities you used to enjoy, such as intimacy and sexual activity, can be a symptom of depression. It’s sometimes hard to know if you’re depressed. Talk with a doctor. Depression can be treated.

Surgery. Many of us worry about having any kind of surgery — it might be even more troubling when the breasts or genital area are involved. Most people do return to the kind of sex life they enjoyed before surgery.

Hysterectomy is surgery to remove a woman’s uterus because of pain, bleeding, fibroids, or other reasons. Often, when an older woman has a hysterectomy, the ovaries are also removed. Deciding whether to have this surgery can leave women worried about their future sex life. Seniors concerned about any changes due to a hysterectomy should talk with a gynecologist or surgeon for more information.

Mastectomy is surgery to remove all or part of a woman’s breast because of breast cancer. This surgery can cause some women to lose their sexual interest, or it might leave them feeling less desirable or attractive to their partners. In addition to talking with a doctor, sometimes it is useful to talk with other women who have had this surgery. Programs like the American Cancer Society’s “Reach to Recovery” can be helpful for both women and men.

Prostatectomy is surgery that removes all or part of a man’s prostate because of cancer or an enlarged prostate. It might cause urinary incontinence or ED. Seniors who need this operation should talk with your doctor before surgery about all concerns.

Medications. Some drugs can cause sexual problems. These include some blood pressure medicines, antihistamines, antidepressants, tranquilizers, Parkinson’s disease or cancer medications, appetite suppressants, drugs for mental problems, and ulcer drugs. Some can lead to ED or make it hard for men to ejaculate. Some drugs can reduce a woman’s sexual desire or cause vaginal dryness or difficulty with arousal and orgasm. Check with your doctor to see if there is a different drug without this side effect.

Alcohol. Too much alcohol can cause erection problems in men and delay orgasm in women.

What can older adults do to maintain a good sex life?

There are things older adults can do for an active and enjoyable sex life. If the senior has a long-term partner, he or she can take time to enjoy each other and understand the changes both are facing.

Seniors shouldn’t be afraid to talk with a doctor if there is a problem that affects one’s sex life. He or she might be able to suggest a treatment. For example, the most common sexual difficulty of older women is painful intercourse caused by vaginal dryness. A doctor or a pharmacist can suggest over-the-counter vaginal lubricants or moisturizers to use. Water-based lubricants are helpful when needed to make sex more comfortable. Moisturizers are used on a regular basis, every two or three days. Or, your doctor might suggest a form of vaginal estrogen.

If ED is the problem, it can often be managed and perhaps even reversed with medication or other treatments. There are pills that can help. They should not be used by men taking medicines containing nitrates, such as nitroglycerin. The pills do have possible side effects. Be wary of any dietary or herbal supplements promising to treat ED. Seniors should always talk to a doctor before taking any herb or supplement.

Physical problems can change your sex life as you get older. If a senior is single, dating, and meeting new people,  doing so might actually be easier later in life because the senior might be confident and might know better what he or she wants. If a senior in a relationship, he or she can discover new ways to be together with his or her partner as they get older. Seniors should talk to partner or partners about their needs. Older adults might find that affection — hugging, kissing, touching, and spending time together — can be just what a senior needs to put him or her on a path to greater intimacy and sex.

Information courtesy of the National Institute on Aging.

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